| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.62 | $89.62 | $185.95 | |
Aetna
| Professional | $78.41 | $89.62 | $89.62 | |
Cigna
| Facility | $85.11 | $145.62 | $294.47 | |
Cigna
| Professional | $128.44 | $128.44 | $160.55 | |
Medcost
| Facility | $58.25 | $89.62 | $112.02 | |
Medcost
| Professional | $72.81 | $112.02 | $112.02 | |
United
| Professional | $56.01 | $56.01 | $112.02 | |
Wellcare
| Facility | $194.91 | $532.10 | $532.10 |